Healthcare Provider Details

I. General information

NPI: 1528422458
Provider Name (Legal Business Name): NICHOLE DAWKINS RIMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S ORLANDO AVE STE E
MAITLAND FL
32751-6471
US

IV. Provider business mailing address

1515 S ORLANDO AVE STE E
MAITLAND FL
32751-6471
US

V. Phone/Fax

Practice location:
  • Phone: 407-603-6272
  • Fax:
Mailing address:
  • Phone: 407-860-0639
  • Fax: 407-505-6373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH24598
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberIMH24598
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberIMH24598
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPMT220
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberIMH24598
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCMS.0102720
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: